Page 20 - Community Living Issue 31-3

medication
stomp on the chemical cosh

Thousands of people with learning disabilities are taking psychotropic drugs they do not need.
seán kelly talks to Anne Webster and Carl Shaw, who lead STOMP, a welcome NHS England
initiative to tackle the curse of overmedication

pproximately 35,000 people with goals for each of the three years – its first satisfied with this answer and asked about
learning disabilities, autism or both annual report was recently published their medication. Shaw wrote a report
atake unnecessary psychotropic (STOMP, 2017). and fed back to the staff and manager
medicines every day, according to a 2015 who then started to look at their
report from Public Health England. Why is overmedication happening? prescriptions.
Psychotropic medicine is usually used to Psychotropic medication can be a Webster and Shaw sometimes find
treat psychosis, depression, anxiety and response to difficult situations such as people think the issue is simple to
sleep disorders. It also includes epilepsy self-harm, harm to others or displays of address. Some think that all you have to
medication when this is used only for its behaviour seen as challenging. do to solve the problem of overmedication
calming effect rather than to treat epilepsy. Webster says that is it understandable is to speak to doctors. STOMP’s approach
However, in the cases that PHE looked at, that carers sometimes go to a GP “feeling is to reach out to all the different
there was no diagnosis or medical desperate and looking for help”. GPs in professions, social care providers and
justification. The medication was simply turn can “feel they are put on the spot, families. It is a “whole system” issue. They
being used to control behaviour. and may prescribe this kind of medication strongly believe that awareness is needed
“ But if we take them practice becomes ingrained when people “but if we take them off medication we’ll
right across the system.
to help a stressed carer manage”. The
They have heard professionals saying
get repeat prescriptions and do not have
regular medication checks. The person’s
have to find more for them to do”.
off medication we’ll
Shocking as this attitude is, Webster and
sedated state can start to seem normal
have to find more for
STOMP tell me, 35,000 people is enough to ” to others. Shaw are keen to avoid simply blaming
people and to find ways to develop better
Shaw tells me about when, as quality
them to do
auditor, he visited a service and met two
awareness. Their approach is that
everyone has a responsibility to challenge
people who used wheelchairs and did not
As Anne Webster and Carl Shaw from
communicate with words. When he
overmedication.
Regular medication reviews are
fill a large football ground. It is a shocking turned up at 8am, the two people were essential to ensure that anything taken is
already up and dressed, alert and ready.
figure so I am pleased to meet up with He then noticed that, for the rest of the really needed. Webster also points out
them to hear more about this NHS England day, they seemed very tired. the importance of finding out what is
initiative to create awareness and tackle the When he asked why, he was told that it going on for the person – are they bored,
problem. STOMP stands for Stop Over- was just because they had profound frustrated or even in pain? These things
Medicating People. “It’s a great name,” I learning disabilities. However, he was not can lead to the kind of behaviour that is
say, “you have got my support already.” “treated” with medication.
Webster trained as a learning disability One strand of work has been the
nurse and previously worked with the STOMP pledge. In 2016, the Royal
Improving Lives team, who carried out Colleges of Nursing, Psychiatry and
reviews of everyone who had been an General Practitioners joined forces
inpatient at Winterbourne View. with the Royal Pharmaceutical Society,
Shaw, a man with learning disabilities, the British Psychological Society, NHS
used to work for care provider Dimensions England and the health minister to sign
as a quality auditor. up to take real and measurable steps
Together they lead the STOMP project, against overmedication.
which is halfway into a three-year span. STOMP then developed a social care
Many people must have suspected that pledge, which 150 social care organisations
overmedication goes on but the PHe supporting more than 50,000 people with
report put a reliable figure on it for the learning disabilities, autism or both signed
first time. After the report’s publication, up to, promising to take practical steps to
NHS england promised a swift response, reduce unnecessary psychotropic
which led to STOMP being set up. medication. These organisations report
Webster and Shaw lead a small team of regularly to STOMP about their progress. A
staff, which includes three part-time new healthcare provider pledge will be
pharmacists and a project coordinator. A launched in April this year.
family carer advises. Fluoxetine was among the drugs mentioned in STOMP’s first report features the story
STOMP has a project plan with clear the Public Health England report of 16-year-old Josh Wills, who has

20 Vol 31 No 3 | Spring 2018 community Living www.cl-initiatives.co.uk